Individual
BRANDON GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 HUNTINGDON DR, WILLIAMSTOWN, NJ 08094-8830
(619) 694-7780
Mailing address
300 HUNTINGDON DR, WILLIAMSTOWN, NJ 08094-8830
(619) 694-7780
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
G73050966102892
NJ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
G73050966102892
NJ
Other
Enumeration date
08/26/2014
Last updated
08/26/2014
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